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Borho L, Bao R, Elishaev E, Dinkins KD, O'Brien EE, Berger J, Boisen M, Comerci J, Courtney-Brooks M, Edwards RP, Garrett AA, Kelley JL, Lesnock J, Mahdi HS, Olawaiye A, Rush S, Sukumvanich P, Taylor S, Arend RC, Norian L, Modugno F. Association of allostatic load with overall survival in epithelial ovarian cancer. Gynecol Oncol 2024; 186:204-210. [PMID: 38843663 PMCID: PMC11216875 DOI: 10.1016/j.ygyno.2024.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/20/2024] [Accepted: 05/28/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE Elevated allostatic load (AL), an integrated, cumulative marker of physiologic damage due to socioenvironmental stress, is associated with increased mortality in patients with breast, lung, and other cancers. The relationship between allostatic load and mortality in ovarian cancer patients remains unknown. We examined the relationship between allostatic load and overall survival in ovarian cancer patients. METHODS This cross-sectional study used data from 201 patients enrolled in a prospective observational ovarian cancer cohort study at a National Cancer Institute-designated Comprehensive Cancer Center from October 2012 through June 2022. All patients underwent debulking surgery and completed a full course of standard-of-care platinum-based chemotherapy. Follow-up was completed through January 2024. Allostatic load was calculated as a summary score by assigning one point to the worst sample quartile for each of ten biomarkers measured within 45 days before the ovarian cancer diagnosis. High allostatic load was defined as having an allostatic load in the top quartile of the summary score. A Cox proportional hazard model with robust variance tested the association between allostatic load and overall survival. RESULTS There were no associations between allostatic load and ovarian cancer clinical characteristics. After accounting for demographic, clinical, and treatment factors, high allostatic load was associated with a significant increase in mortality (hazard ratio 2.17 [95%CI, 1.13-4.15]; P = 0.02). CONCLUSION Higher allostatic load is associated with worse survival among ovarian cancer patients. Allostatic load could help identify patients at risk for poorer outcomes who may benefit from greater socioenvironmental support during treatment.
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Affiliation(s)
- Lauren Borho
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Riyue Bao
- Department of Hematology/Oncology, University of Pittsburgh School of Medicine and Hillman Cancer Center, Pittsburgh, PA, United States of America
| | - Esther Elishaev
- Department of Pathology, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Kaitlyn D Dinkins
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine and O'Neal Comprehensive Cancer Center, Birmingham, AL, United States of America
| | - Emily E O'Brien
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Jessica Berger
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Michelle Boisen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - John Comerci
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Madeleine Courtney-Brooks
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Robert P Edwards
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Alison Aunkst Garrett
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Joseph L Kelley
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Jamie Lesnock
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Haider S Mahdi
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Alexander Olawaiye
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Shannon Rush
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Paniti Sukumvanich
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Sarah Taylor
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America
| | - Rebecca C Arend
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine and O'Neal Comprehensive Cancer Center, Birmingham, AL, United States of America
| | - Lyse Norian
- Department of Nutrition Sciences, University of Alabama at Birmingham School of Health Professions, Nutrition Obesity Research Center, O'Neal Comprehensive Cancer Center, Birmingham, AL, United States of America
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee-Womens Research Institute and Foundation, Pittsburgh, PA, United States of America; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States of America; Women's Cancer Research Center, Magee-Womens Research Institute and Foundation and Hillman Cancer Center, Pittsburgh, PA, United States of America
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Holochwost SJ, Volpe VV, Collins AN, Propper CB, Mills-Koonce WR, Brown ED, Jaffee SR. Allostatic Load in Childhood, Adolescence, and Young Adulthood: Are Assumptions of Measurement Invariance Warranted? Psychosom Med 2024; 86:169-180. [PMID: 38588495 DOI: 10.1097/psy.0000000000001292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OVERVIEW Allostatic load represents the cumulative toll of chronic mobilization of the body's stress response systems, as indexed by biomarkers. Higher levels of stress and disadvantage predict higher levels of allostatic load, which, in turn, predict poorer physical and mental health outcomes. To maximize the efficacy of prevention efforts, screening for stress- and disadvantage-associated health conditions must occur before middle age-that is, during childhood, adolescence, and young adulthood. However, this requires that models of allostatic load display properties of measurement invariance across age groups. Because most research on allostatic load has featured older adults, it is unclear if these requirements can be met. METHODS To address this question, we fit a series of exploratory and confirmatory analytic models to data on eight biomarkers using a nationally representative sample of N = 4260 children, adolescents, and young adults drawn from the National Health and Nutrition Examination Survey dataset. RESULTS Exploratory and confirmatory models indicated that, consistent with allostatic load theory, a unidimensional model was a good fit to the data. However, this model did not display properties of measurement invariance; post-hoc analyses suggested that the biomarkers included in the final confirmatory model were most strongly intercorrelated among young adults and most weakly intercorrelated among adolescents. CONCLUSIONS These results underscore the importance of testing assumptions about measurement invariance in allostatic load before drawing substantive conclusions about stress, disadvantage, and health by directly comparing levels of allostatic load across different stages of development, while underscoring the need to expand investigations of measurement invariance to samples of longitudinal data.
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Affiliation(s)
- Steven J Holochwost
- From the Department of Psychology (Holochwost), Lehman College, The City University of New York, Bronx, New York; Department of Psychology (Volpe, Collins), North Carolina State University, Raleigh; School of Nursing (Propper) and School of Education (Mills-Koonce), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychology (Brown), West Chester University, West Chester; and Department of Psychology (Jaffee), University of Pennsylvania, Philadelphia, Pennsylvania
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3
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Zotova TY, Lukanina AA, Blagonravov ML. Parameters of Hemodynamic Allostasis in Patients of Various Age Groups with Essential Arterial Hypertension. Bull Exp Biol Med 2022; 173:583-589. [PMID: 36210423 DOI: 10.1007/s10517-022-05592-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Indexed: 06/16/2023]
Abstract
We determined the criteria for the diagnosis of hemodynamic allostasis and compared it with the index of allostatic load in patients of different age group with essential arterial hypertension without metabolic syndrome. The study included 87 subjects divided into 3 groups: patients with essential arterial hypertension at the age ⩽60 years (n=31; group 1), patients with essential arterial hypertension above 60 years (n=41; group 2), and healthy volunteers (n=15; age 25-69 years, group 3). The data of 24-h BP monitoring were processed by methods of linear and nonlinear rhythm analysis. Based on the analysis, parameters were identified that allow determining the state of allostatic regulation of the 24-h dynamics of BP, as well as parameters that determine the allostatic hemodynamic load on the cardiovascular system. The data obtained were compared with the index of allostatic load in patients of both groups. Regulation of the hemodynamics in patients with essential hypertension without metabolic syndrome in both age groups remained within the limits of hemodynamic allostasis forming the allostatic load on the body, which does not depend on patient's age.
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Affiliation(s)
- T Yu Zotova
- V. A. Frolov Department of General Pathology and Pathological Physiology, Institute of Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia.
| | - A A Lukanina
- V. A. Frolov Department of General Pathology and Pathological Physiology, Institute of Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - M L Blagonravov
- V. A. Frolov Department of General Pathology and Pathological Physiology, Institute of Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
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4
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Obeng-Gyasi S, Li Y, Carson WE, Reisenger S, Presley CJ, Shields PG, Carbone DP, Ceppa DP, Carlos RC, Andersen BL. Association of Allostatic Load With Overall Mortality Among Patients With Metastatic Non-Small Cell Lung Cancer. JAMA Netw Open 2022; 5:e2221626. [PMID: 35797043 PMCID: PMC9264034 DOI: 10.1001/jamanetworkopen.2022.21626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/11/2022] [Indexed: 01/13/2023] Open
Abstract
Importance Adverse social determinants of health (SDHs) (eg, poverty) are associated with poor oncologic outcomes among patients with lung cancer. However, no studies have evaluated biological correlates of adverse SDHs, operationalized as allostatic load (AL), with mortality due to lung cancer. Objective To examine the association among AL, SDHs, and mortality among patients with metastatic non-small cell lung cancer (NSCLC). Design, Setting, and Participants This cross-sectional study of an observational cohort was performed at a National Cancer Institute-designated comprehensive cancer center with data accrued from June 1, 2017, to August 31, 2019. Patients with metastatic (stage IV) NSCLC enrolled at diagnosis into a prospective observational cohort study were included in the present analysis if they had all the biomarkers to calculate an AL score (N = 143). Follow-up was completed on August 31, 2021, and data were analyzed from July 1 to September 30, 2021. Exposures Social determinants of health. Main Outcomes and Measures Overall mortality and AL. Results A total of 143 patients met the study criteria with a median age of 63 (IQR, 55-71) years (89 men [62.2%] and 54 women [37.8%]). In terms of race and ethnicity, 1 patient (0.7%) was Asian, 7 (4.9%) were Black, 117 (81.8%) were White, 17 (11.9%) were of multiple races, and 1 (0.7%) was of other race or ethnicity. The mean (SD) AL was 2.90 (1.37). Elevated AL covaried with lower educational level (r = -0.26; P = .002), male sex (r = 0.19; P = .02), limited mobility (r = 0.19; P = .04), worsening self-care (r = 0.30; P < .001), problems engaging in usual activities (r = 0.21; P = .01), depressive symptoms (r = 0.23; P = .005), and a high number of stressful life events (r = 0.30; P < .001). Multivariable analysis found only increasing difficulty with mobility (r = 0.37 [95% CI, 0.13-0.60]; P = .002) and male sex (r = 0.63 [95% CI, 0.19-1.08]; P = .005) associated with higher AL. On adjusted analysis, elevated AL (hazard ratio, 1.43 [95% CI, 1.16-1.79]; P = .001) and low educational level (hazard ratio, 2.11 [95% CI, 1.03-4.34]; P = .04) were associated with worse overall mortality. Conclusions and Relevance The findings of this cross-sectional study suggest that higher AL was associated with adverse SDHs and worse overall mortality among patients with advanced NSCLC. These results provide a framework for replication and further studies of AL as a biological correlate for SDH and future prognostic marker.
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Affiliation(s)
- Samilia Obeng-Gyasi
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus
| | - Yaming Li
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - William E. Carson
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus
| | - Sarah Reisenger
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus
| | - Carolyn J. Presley
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus
| | - Peter G. Shields
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus
| | - David P. Carbone
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus
| | - DuyKhanh P. Ceppa
- Department of Surgery, Indiana University School of Medicine, Indianapolis
| | - Ruth C. Carlos
- University of Michigan Comprehensive Cancer Center, Ann Arbor
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Sandifer PA, Juster RP, Seeman TE, Lichtveld MY, Singer BH. Allostatic load in the context of disasters. Psychoneuroendocrinology 2022; 140:105725. [PMID: 35306472 PMCID: PMC8919761 DOI: 10.1016/j.psyneuen.2022.105725] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/28/2022] [Accepted: 03/10/2022] [Indexed: 11/18/2022]
Abstract
Environmental disasters, pandemics, and other major traumatic events such as the Covid-19 pandemic or war contribute to psychosocial stress which manifests in a wide range of mental and physical consequences. The increasing frequency and severity of such events suggest that the adverse effects of toxic stress are likely to become more widespread and pervasive in the future. The allostatic load (AL) model has important elements that lend themselves well for identifying adverse health effects of disasters. Here we examine several articulations of AL from the standpoint of using AL to gauge short- and long-term health effects of disasters and to provide predictive capacity that would enable mitigation or prevention of some disaster-related health consequences. We developed a transdisciplinary framework combining indices of psychosocial AL and physiological AL to produce a robust estimate of overall AL in people affected by disasters and other traumatic events. In conclusion, we urge researchers to consider the potential of using AL as a component in a proposed disaster-oriented human health observing system.
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Affiliation(s)
- Paul A Sandifer
- Center for Coastal Environmental and Human Health, School of Sciences and Mathematics, College of Charleston, 66 George Street, Charleston, SC 29424, USA.
| | - Robert-Paul Juster
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Canada
| | - Teresa E Seeman
- David Geffen School of Medicine at UCLA, University of California Los Angeles, CA, USA
| | - Maureen Y Lichtveld
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Burton H Singer
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
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6
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Kezios KL, Suglia SF, Doyle DM, Susser E, Bradwin G, Cirillo P, Cohn B, Link B, Factor-Litvak P. Comparing different operationalizations of allostatic load measured in mid-life and their patterning by race and cumulative life course socioeconomic status. Psychoneuroendocrinology 2022; 139:105689. [PMID: 35202971 PMCID: PMC8977239 DOI: 10.1016/j.psyneuen.2022.105689] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/05/2022] [Accepted: 02/10/2022] [Indexed: 12/25/2022]
Abstract
Since its conceptualization, there has been a lack of consensus on the best way to operationalize allostatic load (AL). As a marker of the cumulative, physiological wear and tear on the body resulting from chronic exposure to stressors, it follows that AL should be higher among people who have faced more stressful life experiences. Thus, the purpose of this study was to construct AL scores using different operationalizations and, as a measure of construct validity, compare whether each construction produced expected disparities in AL by race and a composite socioeconomic status (SES) variable which accounts for measures over the life course; we also explored differences by sex. We conducted the study in a sample of 45-52-year-old offspring from the Child Health and Development Studies, a longitudinal birth cohort established in the early 1960s. AL scores were constructed in 6 different ways and included 10 biomarkers from inflammatory, neuroendocrine, cardiovascular, and metabolic systems. Our main approach to constructing AL was to sum across high-risk biomarker quartiles, correct for medication use, and use sex-specific high-risk quartiles for specific biomarkers. Alternative constructions did not use sex-specific quartiles and/or weighted biomarkers within subsystems and/or did not correct for medication use. We estimated differences in AL scores by race, SES, sex and their pairwise interactions. All constructions of AL, including the main approach, produced expected disparities by race (higher scores for Black vs. non-Black participants) and life course SES (higher scores for low vs. high SES participants). However, disparities by sex only emerged when the AL score was constructed via approaches that did not use sex-specific high-risk quartiles; for these alternative constructions, overall, female participants had higher AL scores than male participants and Black female participants had the highest AL scores in the sample. For most constructions, the pairwise interaction between sex and SES, showed a stronger disparity in AL scores between low and high-SES female compared with low- and high-SES male participants; this suggests that, in terms of lowering AL, high life course SES may be more important for female than male participants. In conclusion, our results suggest that the basic AL concept is consistently expressed in different operationalizations, making it an especially useful and robust tool for understanding disparities by race and SES.
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Affiliation(s)
- Katrina L. Kezios
- Department of Epidemiology, Mailman School of Public Health, New York, NY,Corresponding author: 722 W. 168th Street, Room 504, New York, NY, USA. . (K.L. Kezios)
| | - Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Ezra Susser
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY
| | - Gary Bradwin
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, MA
| | - Piera Cirillo
- Child Health and Development Studies, Public Health Institute, Berkeley, CA
| | - Barbara Cohn
- Child Health and Development Studies, Public Health Institute, Berkeley, CA
| | - Bruce Link
- Department of Sociology, University of California Riverside, Riverside, CA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, New York, NY
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7
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Guidi J, Lucente M, Sonino N, Fava GA. Allostatic Load and Its Impact on Health: A Systematic Review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:11-27. [PMID: 32799204 DOI: 10.1159/000510696] [Citation(s) in RCA: 393] [Impact Index Per Article: 131.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/06/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. OBJECTIVE To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. METHODS PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. RESULTS A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. CONCLUSIONS The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.
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Affiliation(s)
- Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy,
| | | | - Nicoletta Sonino
- Department of Statistical Sciences, University of Padova, Padova, Italy.,Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
| | - Giovanni A Fava
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
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Solo-Gabriele HM, Fiddaman T, Mauritzen C, Ainsworth C, Abramson DM, Berenshtein I, Chassignet EP, Chen SS, Conmy RN, Court CD, Dewar WK, Farrington JW, Feldman MG, Ferguson AC, Fetherston-Resch E, French-McCay D, Hale C, He R, Kourafalou VH, Lee K, Liu Y, Masi M, Maung-Douglass ES, Morey SL, Murawski SA, Paris CB, Perlin N, Pulster EL, Quigg A, Reed DJ, Ruzicka JJ, Sandifer PA, Shepherd JG, Singer BH, Stukel MR, Sutton TT, Weisberg RH, Wiesenburg D, Wilson CA, Wilson M, Wowk KM, Yanoff C, Yoskowitz D. Towards integrated modeling of the long-term impacts of oil spills. MARINE POLICY 2021; 131:1-18. [PMID: 37850151 PMCID: PMC10581399 DOI: 10.1016/j.marpol.2021.104554] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Although great progress has been made to advance the scientific understanding of oil spills, tools for integrated assessment modeling of the long-term impacts on ecosystems, socioeconomics and human health are lacking. The objective of this study was to develop a conceptual framework that could be used to answer stakeholder questions about oil spill impacts and to identify knowledge gaps and future integration priorities. The framework was initially separated into four knowledge domains (ocean environment, biological ecosystems, socioeconomics, and human health) whose interactions were explored by gathering stakeholder questions through public engagement, assimilating expert input about existing models, and consolidating information through a system dynamics approach. This synthesis resulted in a causal loop diagram from which the interconnectivity of the system could be visualized. Results of this analysis indicate that the system naturally separates into two tiers, ocean environment and biological ecosystems versus socioeconomics and human health. As a result, ocean environment and ecosystem models could be used to provide input to explore human health and socioeconomic variables in hypothetical scenarios. At decadal-plus time scales, the analysis emphasized that human domains influence the natural domains through changes in oil-spill related laws and regulations. Although data gaps were identified in all four model domains, the socioeconomics and human health domains are the least established. Considerable future work is needed to address research gaps and to create fully coupled quantitative integrative assessment models that can be used in strategic decision-making that will optimize recoveries from future large oil spills.
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Affiliation(s)
- Helena M. Solo-Gabriele
- Department of Civil, Architectural, and Environmental Engineering, University of Miami, Coral Gables, FL 33146, USA
| | | | - Cecilie Mauritzen
- Department of Climate, Norwegian Meteorological Institute, Oslo, Norway
| | - Cameron Ainsworth
- College of Marine Science, University of South Florida, St. Petersburg, FL 33701, USA
| | - David M. Abramson
- School of Global Public Health, New York University, New York, NY 10003, USA
| | - Igal Berenshtein
- Department of Ocean Sciences, Rosenstiel School of Marine and Atmospheric Science, University of Miami, Miami, FL 33149, USA
- Cooperative Institute for Marine and Atmospheric Studies, Rosenstiel School of Marine and Atmospheric Science, University of Miami, Miami, FL 33149, USA
| | - Eric P. Chassignet
- Center for Ocean-Atmospheric Prediction Studies, Florida State University, Tallahassee, FL 32306, USA
| | - Shuyi S. Chen
- Department of Atmospheric Sciences, University of Washington, Seattle, WA, USA
| | - Robyn N. Conmy
- Office of Research and Development, US Environmental Protection Agency, Cincinnati, OH 45268, USA
| | - Christa D. Court
- Food and Resource Economics Department, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL 32611, USA
| | - William K. Dewar
- Laboratoire de Glaciologie et Geophysique de l’Environnement, French National Center for Scientific Research (CNRS), Grenoble, France 38000, and Department of Earth, Ocean, and Atmospheric Science, Florida State University, Tallahassee, FL 32306, USA
| | | | - Michael G. Feldman
- Consortium for Ocean Leadership, Gulf of Mexico Research Initiative, Washington, DC 20005, USA
| | - Alesia C. Ferguson
- Built Environment Department, College of Science and Technology, North Carolina Agricultural and Technical State University, Greensboro, NC 27411, USA
| | | | | | - Christine Hale
- Harte Research Institute for Gulf of Mexico Studies, Texas A&M University Corpus Christi, Corpus Christi, TX 78412, USA
| | - Ruoying He
- Dept. of Marine, Earth, and Atmospheric Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - Vassiliki H. Kourafalou
- Department of Ocean Sciences, Rosenstiel School of Marine and Atmospheric Science, University of Miami, Miami, FL 33149, USA
| | - Kenneth Lee
- Fisheries and Oceans Canada, Ecosystem Science, Ottawa, Ontario, K1A 0E6, Canada
| | - Yonggang Liu
- College of Marine Science, University of South Florida, St. Petersburg, FL 33701, USA
| | - Michelle Masi
- Southeast Fisheries Science Center, National Marine Fisheries Service, NOAA, Galveston, TX 77551, USA
| | | | - Steven L. Morey
- School of the Environment, Florida Agricultural and Mechanical University, Tallahassee, FL 32307, USA
| | - Steven A. Murawski
- College of Marine Science, University of South Florida, St. Petersburg, FL 33701, USA
| | - Claire B. Paris
- Department of Ocean Sciences, Rosenstiel School of Marine and Atmospheric Science, University of Miami, Miami, FL 33149, USA
| | - Natalie Perlin
- Department of Atmospheric Sciences, Rosenstiel School of Marine and Atmospheric Science, University of Miami, Miami, FL 33149, USA
| | - Erin L. Pulster
- College of Marine Science, University of South Florida, St. Petersburg, FL 33701, USA
| | - Antonietta Quigg
- Department of Marine Biology, Texas A&M University at Galveston, Galveston, TX 77553, USA
| | - Denise J. Reed
- Pontchartrain Institute for Environmental Sciences, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA 70148, USA
| | - James J. Ruzicka
- Cooperative Institute for Marine Resources Studies, Oregon State University, Newport, OR 97365, USA
| | - Paul A. Sandifer
- Center for Coastal Environmental and Human Health, College of Charleston, Charleston, SC 29424, USA
| | - John G. Shepherd
- School of Ocean & Earth Science, National Oceanography Centre, University of Southampton, Southampton SO14 3ZH, UK
| | - Burton H. Singer
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Michael R. Stukel
- Department of Earth, Ocean, and Atmospheric Science, Florida State University, Tallahassee, FL 32306, USA
| | - Tracey T. Sutton
- Guy Harvey Oceanographic Center, Halmos College of Arts and Sciences, Nova Southeastern University, Dania Beach, FL 33004, USA
| | - Robert H. Weisberg
- College of Marine Science, University of South Florida, St. Petersburg, FL 33701, USA
| | - Denis Wiesenburg
- School of Ocean Science and Engineering, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | | | - Monica Wilson
- Florida Sea Grant, University of Florida, St. Petersburg, FL 33701, USA
| | - Kateryna M. Wowk
- Harte Research Institute for Gulf of Mexico Studies, Texas A&M University Corpus Christi, Corpus Christi, TX 78412, USA
| | - Callan Yanoff
- Consortium for Ocean Leadership, Gulf of Mexico Research Initiative, Washington, DC 20005, USA
| | - David Yoskowitz
- Harte Research Institute for Gulf of Mexico Studies, Texas A&M University Corpus Christi, Corpus Christi, TX 78412, USA
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9
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Mathew A, Doorenbos AZ, Li H, Jang MK, Park CG, Bronas UG. Allostatic Load in Cancer: A Systematic Review and Mini Meta-Analysis. Biol Res Nurs 2021; 23:341-361. [PMID: 33138637 PMCID: PMC8755951 DOI: 10.1177/1099800420969898] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Individuals with cancer experience stress throughout the cancer trajectory. Allostatic load (AL), a cumulative multi-system measure, may have a greater value in stress assessment and the associated biological burden than individual biomarkers. A better understanding of the use of AL and its operationalization in cancer could aid in early detection and prevention or alleviation of AL in this population. PURPOSE To consolidate findings on the operationalization, antecedents, and outcomes of AL in cancer. METHODS Seven databases (CINAHL, Ovid MEDLINE, Web of Science, APA PsycInfo, Scopus, Embase, and Cochrane CENTRAL) were searched for articles published through April 2020. The NIH tools were used to assess study quality. RESULTS Twelve studies met inclusion criteria for this review. Although variability existed in the estimation of AL, biomarkers of cardiovascular, metabolic, and immune systems were mostly used. Associations of AL with cancer-specific variables were examined mostly utilizing population-databases. Significant associations of AL with variables such as cancer-related stress, positive cancer history, post traumatic growth, resilience, tumor pathology, and cancer-specific mortality were found. Mini meta-analysis found that a one-unit increase in AL was associated with a 9% increased risk of cancer-specific mortality. CONCLUSION This review reveals heterogeneity in operationalization of AL in cancer research and lack of clarity regarding causal direction between AL and cancer. Nevertheless, AL holds a significant promise in cancer research and practice. AL could be included as a screening tool for high-risk individuals or a health outcome in cancer. Optimal standardized approaches to measure AL would improve its clinical utility.
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Affiliation(s)
- Asha Mathew
- College of Nursing, University of Illinois, Chicago, IL, USA
- College of Nursing, Christian Medical College, Vellore, India
| | - Ardith Z. Doorenbos
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Hongjin Li
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Min Kyeong Jang
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Chang Gi Park
- College of Nursing, University of Illinois, Chicago, IL, USA
- Department of Population Health Nursing Science, Office of Research Facilitation, Chicago, IL, USA
| | - Ulf G. Bronas
- College of Nursing, University of Illinois, Chicago, IL, USA
- Laboratory of Vascular and Cognitive Health, Chicago, IL, USA
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Kallen V, Tahir M, Bedard A, Bongers B, van Riel N, van Meeteren N. Aging and Allostasis: Using Bayesian Network Analytics to Explore and Evaluate Allostatic Markers in the Context of Aging. Diagnostics (Basel) 2021; 11:diagnostics11020157. [PMID: 33494482 PMCID: PMC7912325 DOI: 10.3390/diagnostics11020157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/06/2021] [Accepted: 01/18/2021] [Indexed: 12/30/2022] Open
Abstract
Allostatic load reflects the cumulative strain on organic functions that may gradually evolve into overt disease. Our aim was to evaluate the allostatic parameters in the context of aging, and identify the parameters that may be suitable for an allostatic load index for elderly people (>60 years). From previously published studies, 11 allostatic (bio)markers could be identified that sustain sufficient variability with aging to capture meaningful changes in health status. Based on reported statistics (prevalence of a biomarker and its associated outcome, and/or an odds/risk ratio relating these two), seven of these could be adopted in a Bayesian Belief Network (BBN), providing the probability of “disturbed” allostasis in any given elder. Additional statistical analyses showed that changes in IL-6 and BMI contributed the most to a “disturbed” allostasis, indicating their prognostic potential in relation to deteriorating health in otherwise generally healthy elderly. In this way, and despite the natural decline in variance that irrevocably alters the prognostic relevance of most allostatic (bio)markers with aging, it appeared possible to outline an allostatic load index specifically for the elderly. The allostatic parameters here identified might consequently be considered a useful basis for future quantitative modelling in the context of (healthy) aging.
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Affiliation(s)
- Victor Kallen
- Department of Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 360, 3700 AJ Zeist, The Netherlands; (M.T.); (A.B.)
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Correspondence:
| | - Muhammad Tahir
- Department of Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 360, 3700 AJ Zeist, The Netherlands; (M.T.); (A.B.)
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
| | - Andrew Bedard
- Department of Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 360, 3700 AJ Zeist, The Netherlands; (M.T.); (A.B.)
| | - Bart Bongers
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism/Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Natal van Riel
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Department of Biomedical Engineering, Eindhoven University of Technology, P.O. Box 513, 5300 Eindhoven, The Netherlands
| | - Nico van Meeteren
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Health~Holland, Top Sector Life Sciences and Health, Wilhelmina van Pruisenweg 104, 2595 AN The Hague, The Netherlands
- Erasmus Medical Center, Department of Anesthesiology, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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11
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Acheampong T, Jiang L, Ziogas A, Odegaard AO. Multi-Systemic Biological Risk and Cancer Mortality: The NHANES III Study. Sci Rep 2020; 10:5047. [PMID: 32193496 PMCID: PMC7081240 DOI: 10.1038/s41598-020-61945-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 03/02/2020] [Indexed: 01/16/2023] Open
Abstract
Multi-systemic biological risk (MSBR), a proxy for allostatic load, is a composite index of biomarkers representing dysregulation due to responses to chronic stress. This study examined the association of an MSBR index with cancer mortality. The sample included n = 13,628 adults aged 20–90 from the NHANES III Linked Mortality File (1988–1994). The MSBR index included autonomic (pulse rate, blood pressure), metabolic (HOMAir, triglycerides, waist circumference), and immune (white blood cell count, C-reactive protein) markers. We fit Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CI) of overall cancer mortality risk, according to quartiles (q) of the index. In multivariable models, compared to those in q1, q4 had a 64% increased risk for cancer mortality (HR = 1.64, 95% CI:1.13–2.40). The immune domain drove the association (HR per unit = 1.19, 95% CI:1.07–1.32). In stratified analyses, the HR for those with a BMI ≥ 25 was 1.12 per unit (95% CI:1.05–1.19) and those with a BMI < 25 was 1.04 per unit (95% CI:0.92–1.18). MSBR is positively associated with risk for cancer mortality in a US sample, particularly among those who are overweight or obese. The utilization of standard clinical measures comprising this index may inform population cancer prevention strategies.
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Affiliation(s)
- Teofilia Acheampong
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th street, New York, NY, 10032, United States
| | - Luohua Jiang
- Department of Epidemiology, University of California-Irvine, Anteater Instruction & Research Building (AIRB), 653 E. Peltason Drive, Suite 3060 E, Irvine, CA, 92697, United States
| | - Argyrios Ziogas
- Department of Epidemiology, University of California-Irvine, Anteater Instruction & Research Building (AIRB), 653 E. Peltason Drive, Suite 3060 E, Irvine, CA, 92697, United States
| | - Andrew O Odegaard
- Department of Epidemiology, University of California-Irvine, Anteater Instruction & Research Building (AIRB), 653 E. Peltason Drive, Suite 3060 E, Irvine, CA, 92697, United States.
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12
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Guidi J, Lucente M, Piolanti A, Roncuzzi R, Rafanelli C, Sonino N. Allostatic overload in patients with essential hypertension. Psychoneuroendocrinology 2020; 113:104545. [PMID: 31862612 DOI: 10.1016/j.psyneuen.2019.104545] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/09/2019] [Accepted: 12/09/2019] [Indexed: 02/06/2023]
Abstract
The role of psychosocial stress in the development of essential hypertension has attracted increasing attention in the last decades, even though research findings have been often inconclusive. We specifically investigated allostatic overload (AO) in hypertensive patients using a clinimetric approach. Allostatic overload was assessed by a semi-structured research interview based on clinimetric criteria in 80 consecutive outpatients with essential hypertension (46.3 % females; mean age 62.18 ± 8.59 years; age range 47-74 years) and 80 normotensive matched controls. Three clinical interviews and two self-rating questionnaires for assessing psychological distress and well-being were also administered. Cardiac variables were collected. AO was present in 26 (32.5 %) of the hypertensive patients based on clinical interviewing, and in only 6 normotensive controls (p < .001). Hypertensive patients with AO had significantly higher levels of psychological distress than those without. Further, patients with AO displayed significantly lower levels of well-being and quality of life (p < .001). A significantly greater prevalence of psychosomatic syndromes was found to be associated with the presence of AO (p < .05), whereas no significant association was detected as to psychiatric diagnoses. Significantly greater cardiovascular risk was found among hypertensive patients reporting AO compared to those without (p < .05). The results of this study support the clinical relevance of a psychological assessment of hypertensive patients, with important implications for the non-pharmacological management of hypertension.
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Affiliation(s)
- Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy.
| | | | | | - Renzo Roncuzzi
- Division of Cardiology, Bellaria Hospital, Bologna, Italy
| | | | - Nicoletta Sonino
- Department of Statistical Sciences, University of Padova, Padova, Italy; Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA
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13
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Gillespie SL, Anderson CM, Zhao S, Tan Y, Kline D, Brock G, Odei J, O'Brien E, Sims M, Lazarus SA, Hood DB, Williams KP, Joseph JJ. Allostatic load in the association of depressive symptoms with incident coronary heart disease: The Jackson Heart Study. Psychoneuroendocrinology 2019; 109:104369. [PMID: 31307010 PMCID: PMC7232849 DOI: 10.1016/j.psyneuen.2019.06.020] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/24/2019] [Accepted: 06/28/2019] [Indexed: 12/16/2022]
Abstract
African Americans are at heightened risk for coronary heart disease (CHD), with biologic pathways poorly understood. We examined the role of allostatic load (AL) in the association of depressive symptoms with incident CHD among 2,670 African American men and women in the prospective Jackson Heart Study. Depressive symptoms were quantified using the Center for Epidemiologic Studies Depression Scale (CES-D). Incident CHD was ascertained by self-report, death certificate survey, and adjudicated medical record surveillance. Baseline AL was quantified using biologic parameters of metabolic, cardiovascular, immune, and neuroendocrine subsystems and as a combined meta-factor. Sequential models adjusted for demographic, socioeconomic, and behavioral covariates, stratified to examine differences by sex. Greater depressive symptomatology was associated with greater metabolic, cardiovascular, and immune AL (p-values≤0.036) and AL meta-factor z-scores (p = 0.007), with findings driven by observations among females. Each 1-point increase in baseline depressive symptomatology, and 1-SD increase in metabolic AL, neuroendocrine AL, and AL meta-factor z-scores was associated with 3.3%, 88%, 39%, and 130% increases in CHD risk, respectively (p-values <0.001). Neuroendocrine AL and AL meta-factor scores predicted incident CHD among males but not females in stratified analyses. Metabolic AL partially mediated the association of depressive symptoms with incident CHD (5.79% mediation, p = 0.044), a finding present among females (p = 0.016) but not males (p = 0.840). Among African American adults, we present novel findings of an association between depressive symptomatology and incident CHD, partially mediated by metabolic AL. These findings appear to be unique to females, an important consideration in the design of targeted interventions for CHD prevention.
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Affiliation(s)
- Shannon L Gillespie
- Martha S. Pitzer Center for Women, Children, & Youth, College of Nursing, The Ohio State University, Columbus, OH, United States.
| | - Cindy M Anderson
- Martha S. Pitzer Center for Women, Children, & Youth, College of Nursing, The Ohio State University, Columbus, OH, United States
| | - Songzhu Zhao
- Department of Bioinformatics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Yubo Tan
- Department of Bioinformatics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - David Kline
- Department of Bioinformatics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Guy Brock
- Department of Bioinformatics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - James Odei
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, United States
| | - Emily O'Brien
- Duke Clinical Research Institute and Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, United States
| | - Sophie A Lazarus
- Department of Psychology, The Ohio State University, United States
| | - Darryl B Hood
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, United States
| | - Karen Patricia Williams
- Martha S. Pitzer Center for Women, Children, & Youth, College of Nursing, The Ohio State University, Columbus, OH, United States
| | - Joshua J Joseph
- Division of Endocrinology, Diabetes & Metabolism, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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14
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Fava GA, McEwen BS, Guidi J, Gostoli S, Offidani E, Sonino N. Clinical characterization of allostatic overload. Psychoneuroendocrinology 2019; 108:94-101. [PMID: 31252304 DOI: 10.1016/j.psyneuen.2019.05.028] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 11/19/2022]
Abstract
Allostatic load reflects the cumulative effects of stressful experiences in daily life and may lead to disease over time. When the cost of chronic exposure to fluctuating or heightened neural and systemic physiologic responses exceeds the coping resources of an individual, this is referred to as "toxic stress" and allostatic overload ensues. Its determination has initially relied on measurements of an interacting network of biomarkers. More recently, clinical criteria for the determination of allostatic overload, that provide information on the underlying individual experiential causes, have been developed and used in a number of investigations. These clinimetric tools can increase the number of people screened, while putting the use of biomarkers in a psychosocial context. The criteria allow the personalization of interventions to prevent or decrease the negative impact of toxic stress on health, with particular reference to lifestyle modifications and cognitive behavioral therapy.
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Affiliation(s)
- Giovanni A Fava
- Department of Psychology, University of Bologna, Bologna, Italy; Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA.
| | - Bruce S McEwen
- Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY, USA
| | - Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Sara Gostoli
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Emanuela Offidani
- Department of Behavioral Science and Education, Pennsylvania State University, Schuylkill Haven, PA, USA
| | - Nicoletta Sonino
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA; Department of Statistical Sciences, University of Padova, Padova, Italy
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15
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Russell JA, Brunton PJ. Giving a good start to a new life via maternal brain allostatic adaptations in pregnancy. Front Neuroendocrinol 2019; 53:100739. [PMID: 30802468 DOI: 10.1016/j.yfrne.2019.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/29/2019] [Accepted: 02/21/2019] [Indexed: 12/23/2022]
Abstract
Successful pregnancy requires adjustments to multiple maternal homeostatic mechanisms, governed by the maternal brain to support and enable survival of the growing fetus and placenta. Such adjustments fit the concept of allostasis (stability through change) and have a cost: allostatic load. Allostasis is driven by ovarian, anterior pituitary, placental and feto-placental hormones acting on the maternal brain to promote adaptations that support the pregnancy and protect the fetus. Many women carry an existing allostatic load into pregnancy, from socio-economic circumstances, poor mental health and in 'developed' countries, also from obesity. These pregnancies have poorer outcomes indicating negative interactions (failing allostasis) between pre-pregnancy and pregnancy allostatic loads. Use of animal models, such as adult prenatally stressed female offspring with abnormal neuroendocrine, metabolic and behavioural phenotypes, to probe gene expression changes, and epigenetic mechanisms in the maternal brain in adverse pregnancies are discussed, with the prospect of ameliorating poor pregnancy outcomes.
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Affiliation(s)
- John A Russell
- Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | - Paula J Brunton
- Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK; Zhejiang University-University of Edinburgh Institute, Haining, Zhejiang, PR China.
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16
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Forrester SN, Leoutsakos JM, Gallo JJ, Thorpe RJ, Seeman TE. Association between allostatic load and health behaviours: a latent class approach. J Epidemiol Community Health 2019; 73:340-345. [DOI: 10.1136/jech-2018-211289] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/30/2018] [Accepted: 01/11/2019] [Indexed: 12/26/2022]
Abstract
BackgroundAllostatic load (AL) has been characterised in many ways throughout the literature; however, its relationship to health behaviours has only been studied in limited populations. We aimed to uncover qualitative patterns of biological indicators in AL and determine if those patterns were associated with certain health behaviours.MethodsWe conducted latent class analysis using biological indicators from a multiethnic population. We fit latent class regression of class on health behaviours (smoking, poor diet, physical activity and alcohol use) to measure the association between each latent class of AL and each health behaviour.ResultsFour classes, ‘Metabolic+Cholesterol, ‘Blood Pressure’, ‘Metabolic+Blood Pressure’ and ‘Low’, were found in the sample. Latent class regression showed that physical activity and alcohol use were significantly associated with the ‘Metabolic+Blood Pressure’ class.ConclusionLess physical activity was required to improve AL than was previously found. Low to moderate alcohol use was beneficial for lower AL. Implications of the amount of physical activity necessary to lower AL is discussed.
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Sandifer PA, Walker AH. Enhancing Disaster Resilience by Reducing Stress-Associated Health Impacts. Front Public Health 2018; 6:373. [PMID: 30627528 PMCID: PMC6309156 DOI: 10.3389/fpubh.2018.00373] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 12/06/2018] [Indexed: 12/19/2022] Open
Abstract
Disasters are a recurring fact of life, and major incidents can have both immediate and long-lasting negative effects on the health and well-being of people, communities, and economies. A primary goal of many disaster preparedness, response, and recovery plans is to reduce the likelihood and severity of disaster impacts through increased resilience of individuals and communities. Unfortunately, most plans do not address directly major drivers of long-term disaster impacts on humans-that is, acute, chronic, and cumulative stress-and therefore do less to enhance resilience than they could. Stress has been shown to lead to or exacerbate ailments ranging from mental illness, domestic violence, substance abuse, post-traumatic stress disorders, and suicide to cardiovascular disease, respiratory problems, and other infirmities. Individuals, groups, communities, organizations, and social ties are all vulnerable to stress. Based on a targeted review of what we considered to be key literature about disasters, resilience, and disaster-associated stress effects, we recommend eight actions to improve resiliency through inclusion of stress alleviation in disaster planning: (1) Improve existing disaster behavioral and physical health programs to better address, leverage, and coordinate resources for stress reduction, relief, and treatment in disaster planning and response. (2) Emphasize pre- and post-disaster collection of relevant biomarker and other health-related data to provide a baseline of health status against which disaster impacts could be assessed, and continued monitoring of these indicators to evaluate recovery. (3) Enhance capacity of science and public health early-responders. (4) Use natural infrastructure to minimize disaster damage. (5) Expand the geography of disaster response and relief to better incorporate the displacement of affected people. (6) Utilize nature-based treatment to alleviate pre- and post-disaster stress effects on health. (7) Review disaster laws, policies, and regulations to identify opportunities to strengthen public health preparedness and responses including for stress-related impacts, better engage affected communities, and enhance provision of health services. (8) With community participation, develop and institute equitable processes pre-disaster for dealing with damage assessments, litigation, payments, and housing.
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Affiliation(s)
- Paul A. Sandifer
- Center for Coastal Environmental and Human Health, School of Sciences and Mathematics, College of Charleston, Charleston, SC, United States
- Center for Oceans and Human Health, University of South Carolina, Columbia, SC, United States
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Silva D, Moreira R, Sokhatska O, Beltrão M, Montanha T, Garcia-Larsen V, Villegas R, Severo M, Pizarro A, Pinto M, Martins C, Duarte A, Delgado L, Rufo J, Paciência I, Teixeira JP, Costa C, Moreira P, Carvalho J, Moreira A. Meal-exercise challenge and physical activity reduction impact on immunity and inflammation (MERIIT trial). Contemp Clin Trials Commun 2018; 10:177-189. [PMID: 30009276 PMCID: PMC6042468 DOI: 10.1016/j.conctc.2018.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/13/2018] [Accepted: 05/03/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The effect of a pre-exercise meal as countermeasure to exercise induced immunodepression is poorly known. Also, sedentary behavior is associated with increased cardiometabolic risk but studies on immune changes are lacking. Therefore, we aimed to assess: 1) the impact of a pre-exercise Mediterranean meal (MdM) compared with a fast-food type meal (FFM) on exercise-induced immunological changes and 2) the impact of an induced acute period of sedentary behavior on neuro-immune-endocrine status. METHODS /Design: This is a two steps clinical trial including: (a) randomized crossover clinical trial, comparing the effect a high-fat/low-nutrient dense meal, FFM, with an isoenergetic similar high-nutrient dense meal, MdM, in the immune response to an exercise challenge (EC) and (b) a pilot trial assessing the neuro-immune-endocrine change induced by acute decreasing by half the usual physical activity level. RESULTS A total of 46 participants (26 females), median aged 25 years were included. Of those 39-completed protocol, including overweight, physical active and inactive and participants with asthma. There were no differences in the EC between interventions. Dietary factors and physical activity were closely monitored during interventions and kept similar. During physical inactivity induction, 31% reached the target of 50% reduction in mean step number and 77% reached a 30% reduction. CONCLUSION The use of a pre-exercise meal to modulate immune response and the understanding of the immunological impact of physical inactivity might help to establish future recommendations on how to practice exercise in a safer way and to recognize the potential impact of inactivity.
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Affiliation(s)
- Diana Silva
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
- Serviço de Imunoalergologia, Centro Hospitalar São João, EPE, Porto, Portugal
| | - Rita Moreira
- Faculty of Nutrition and Food Sciences University of Porto, Portugal
| | - Oksana Sokhatska
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
| | - Marília Beltrão
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
| | - Tiago Montanha
- Research Centre in Physical Activity, Health and Leisure - Faculty of Sports, Porto, Portugal
| | - Vanessa Garcia-Larsen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | - Milton Severo
- EPIUnit – Institute of Public Health, University of Porto, Porto, Portugal
| | - Andreia Pizarro
- Research Centre in Physical Activity, Health and Leisure - Faculty of Sports, Porto, Portugal
| | - Mariana Pinto
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
- Faculty of Nutrition and Food Sciences University of Porto, Portugal
| | - Carla Martins
- Serviço de Imunoalergologia, Centro Hospitalar São João, EPE, Porto, Portugal
| | - Ana Duarte
- Department of Environmental Health, Portuguese National Institute of Health, Portugal
| | - Luís Delgado
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
- Serviço de Imunoalergologia, Centro Hospitalar São João, EPE, Porto, Portugal
| | - João Rufo
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
- EPIUnit – Institute of Public Health, University of Porto, Porto, Portugal
| | - Inês Paciência
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
- EPIUnit – Institute of Public Health, University of Porto, Porto, Portugal
| | - João Paulo Teixeira
- Department of Environmental Health, Portuguese National Institute of Health, Portugal
| | - Carla Costa
- Department of Environmental Health, Portuguese National Institute of Health, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Sciences University of Porto, Portugal
| | - Joana Carvalho
- Research Centre in Physical Activity, Health and Leisure - Faculty of Sports, Porto, Portugal
| | - André Moreira
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
- Serviço de Imunoalergologia, Centro Hospitalar São João, EPE, Porto, Portugal
- EPIUnit – Institute of Public Health, University of Porto, Porto, Portugal
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Hellhammer D, Meinlschmidt G, Pruessner JC. Conceptual endophenotypes: A strategy to advance the impact of psychoneuroendocrinology in precision medicine. Psychoneuroendocrinology 2018; 89:147-160. [PMID: 29396321 DOI: 10.1016/j.psyneuen.2017.12.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 01/05/2023]
Abstract
Psychobiological research has generated a tremendous amount of findings on the psychological, neuroendocrine, molecular and environmental processes that are directly relevant for mental and physical health, but have overwhelmed our capacity to meaningfully absorb, integrate, and utilize this knowledge base. Here, we reflect about suitable strategies to improve the translational success of psychoneuroendocrinological research in the era of precision medicine. Following a strategy advocated by the National Research Council and the tradition of endophenotype-based research, we advance here a new approach, termed "conceptual endophenotypes". We define the contextual and formal criteria of conceptual endophenotypes, outline criteria for filtering and selecting information, and describe how conceptual endophenotypes can be validated and implemented at the bedside. As proof-of-concept, we describe some of our findings from research that has adopted this approach in the context of stress-related disorders. We argue that conceptual endophenotypes engineer a bridge between the bench and the bedside. This approach readily lends itself to being continuously developed and implemented. Recent methodological advances, including digital phenotyping, machine learning, grassroots collaboration, and a learning healthcare system, may accelerate the development and implementation of this conceptual endophenotype approach.
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Affiliation(s)
- Dirk Hellhammer
- Department of Psychology, University of Trier, D-54286 Trier, Germany.
| | - Gunther Meinlschmidt
- Department of Psychosomatic Medicine, Faculty of Medicine, University of Basel and University Hospital Basel, Hebelstrasse 2, CH-4031 Basel, Switzerland; Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstrasse 60/62, CH-4055 Basel, Switzerland; Division of Clinical Psychology and Cognitive Behavioral Therapy, International Psychoanalytic University, Stromstrasse 1, D-10555 Berlin, Germany.
| | - Jens C Pruessner
- Department of Psychology, University of Konstanz, D-78457 Konstanz, Germany.
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Bello GA, Teitelbaum SL, Lucchini RG, Dasaro CR, Shapiro M, Kaplan JR, Crane MA, Harrison DJ, Luft BJ, Moline JM, Udasin IG, Todd AC. Assessment of cumulative health risk in the World Trade Center general responder cohort. Am J Ind Med 2018; 61:63-76. [PMID: 29148090 DOI: 10.1002/ajim.22786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Multiple comorbidities have been reported among rescue/recovery workers responding to the 9/11/2001 WTC disaster. In this study, we developed an index that quantifies the cumulative physiological burden of comorbidities and predicts life expectancy in this cohort. METHODS A machine learning approach (gradient boosting) was used to model the relationship between mortality and several clinical parameters (laboratory test results, blood pressure, pulmonary function measures). This model was used to construct a risk index, which was validated by assessing its association with a number of health outcomes within the WTC general responder cohort. RESULTS The risk index showed significant associations with mortality, self-assessed physical health, and onset of multiple chronic conditions, particularly COPD, hypertension, asthma, and sleep apnea. CONCLUSION As an aggregate of several clinical parameters, this index serves as a cumulative measure of physiological dysregulation and could be utilized as a prognostic indicator of life expectancy and morbidity risk.
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Affiliation(s)
- Ghalib A. Bello
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York New York
| | - Susan L. Teitelbaum
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York New York
| | - Roberto G. Lucchini
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York New York
| | - Christopher R. Dasaro
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York New York
| | - Moshe Shapiro
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York New York
| | - Julia R. Kaplan
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York New York
| | - Michael A. Crane
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York New York
| | - Denise J. Harrison
- Department of Environmental Medicine; Bellevue Hospital Center/New York University School of Medicine; New York New York
| | - Benjamin J. Luft
- Department of Medicine; Stony Brook University Medical Center; Stony Brook New York
| | - Jacqueline M. Moline
- Department of Occupational Medicine, Epidemiology and Prevention; Hofstra Northwell School of Medicine at Hofstra University; Hempstead New York
| | - Iris G. Udasin
- Environmental and Occupational Health Sciences Institute; Robert Wood Johnson Medical Center; Piscataway New Jersey
| | - Andrew C. Todd
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York New York
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Acevedo A, Androulakis IP. Allostatic breakdown of cascading homeostat systems: A computational approach. Heliyon 2017; 3:e00355. [PMID: 28761937 PMCID: PMC5522379 DOI: 10.1016/j.heliyon.2017.e00355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/26/2017] [Accepted: 07/06/2017] [Indexed: 12/30/2022] Open
Abstract
Homeostasis posits that physiological systems compensate setpoint deviations in an attempt to maintain a state of internal constancy. Allostasis, on the other hand, suggests that physiological regulation is more appropriately described by predictive modulatory actions that, by adjusting setpoints, anticipate and react to changes in internal and external demand. In other words, “maintaining stability through change.” The allostatic perspective enabled the rationalization of predictive and reactive homeostasis. While the latter reflects external perturbations, the former refers to systemic adaptation in response to anticipated changes − not necessarily related to unexpected external disturbances. Therefore, the concept of allostasis accounts also for adaptation to circadian variations (seasonal, circannual or other predictive variability) and interprets the system’s adaptation of its setpoints not as reactive/subnormal adjustments, but rather as a proper response. Therefore, systemic entrainment to periodic demands is handled by predicting and implementing setpoint changes. Given the important role of circadian variability and regulation in maintaining health, and the loss of circadian entrainment as a predisposing factor and sequel of stress, we elaborate on an allostasis model which demonstrates the ability of the systems to adapt to circadian demands and quantifies the deteriorative natural wear and tear of a system constantly adapting, i.e. the irreversible damage and its consequences on system function and overall survival. While developing a system of cascaded nature, we demonstrate the importance of phase coordination and the implications of maintaining proper phase relations. The disruption of these relations is a hallmark of circadian disruption, a predisposing factor to increased vulnerability and/or a sequel to chronic stress.
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Affiliation(s)
- Alison Acevedo
- Biomedical Engineering Department, Rutgers University, United States
| | - Ioannis P Androulakis
- Biomedical Engineering Department, Rutgers University, United States.,Chemical and Biochemical Engineering Department, Rutgers University, United States.,Department of Surgery, Rutgers-Robert Wood Johnson Medical School, United States
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Seeman M, Stein Merkin S, Karlamangla A, Koretz B, Seeman T. Social status and biological dysregulation: the "status syndrome" and allostatic load. Soc Sci Med 2014; 118:143-51. [PMID: 25112569 DOI: 10.1016/j.socscimed.2014.08.002] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 08/01/2014] [Accepted: 08/04/2014] [Indexed: 01/30/2023]
Abstract
Data from a national sample of 1255 adults who were part of the MIDUS (Mid-life in the U.S.) follow-up study and agreed to participate in a clinic-based in-depth assessment of their health status were used to test the hypothesis that, quite part from income or educational status, perceptions of lower achieved rank relative to others and of relative inequality in key life domains would be associated with greater evidence of biological health risks (i.e., higher allostatic load). Results indicate that over a variety of status indices (including, for example, the person's sense of control, placement in the community rank hierarchy, perception of inequality in the workplace) a syndrome of perceived relative deprivation is associated with higher levels of biological dysregulation. The evidence is interpreted in light of the well-established associations between lower socio-economic status and various clinically identified health morbidities. The present evidence serves, in effect, both as a part of the explanation of how socio-economic disparities produce downstream morbidity, and as an early warning system regarding the ultimate health effects of currently increasing status inequalities.
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Affiliation(s)
- Melvin Seeman
- Department of Sociology, University of California, Los Angeles, CA, USA
| | - Sharon Stein Merkin
- Department of Medicine/Division of Geriatrics, University of California, Los Angeles, CA, USA
| | - Arun Karlamangla
- Department of Medicine/Division of Geriatrics, University of California, Los Angeles, CA, USA
| | - Brandon Koretz
- Department of Medicine/Division of Geriatrics, University of California, Los Angeles, CA, USA
| | - Teresa Seeman
- Department of Medicine/Division of Geriatrics, University of California, Los Angeles, CA, USA.
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